Straightforward fix for toddler's tear duct problem

Yes, the parents had been a bit traumatized to see their little toddler being wheeled off to the outpatient surgical suite, but now several weeks post-op, I assured the mother that they made the right decision. Her 15-month-old's eye problem was not life threatening, but her condition was bothersome and was clearly not going to correct itself without medical intervention.

The mother had to admit that as nervous as she had been watching her daughter undergo general anesthesia and surgical probing of the tear ducts, she was now very pleased with the outcome. The girl also seemed happy since she was able to play without constantly rubbing her beautiful eyes. In addition, she no longer had the eye tearing and the icky, thick eye discharge that friends and family often mistook for contagious pink eye.

According to experts at the American Association for Pediatric Ophthalmology and Strabismus, a blocked tear duct is found in about 5 percent (some sources say as high as 20 percent) of infants, and can affect one or both eyes.

Tears drain from the eye to the nose by passing through the small holes, or puncta, on the nasal side of the eyelids and on through the nasolacrimal duct alongside the nose. A blocked tear duct or nasolacrimal duct obstruction causes an interruption in this system of flow, leading to the accumulation of tears and often eye discharge.

Ophthalmologists explain that childhood tear duct obstruction usually occurs when the membrane at the base of the nasolacrimal duct fails to open at birth. This eye condition can also occur if eyelid puncta do not develop normally; if part or all of the tear duct drainage system is narrowed; when the nasal bone itself obstructs the tear duct; or in certain cases, as the result of eye infections.

AAPOS specialists note that 90 percent of congenital tear duct blockages will resolve sometime during the first 12 months of life. Time and a little good luck are usually the only cure needed. Nonsurgical treatments include several-times-a-day tear duct massage, which can sometimes help to open the blocked duct, as well as the use of topical antibiotic drops or ointment, which will treat any coexisting eye infections.

When eye symptoms persist, it becomes evident that an older infant is now part of the 10 percent minority whose tear duct drainage system will not open up on its own. An ophthalmologist is then consulted and the decision is often made to intervene with a brief surgical procedure called tear duct probing.

Although the procedure is usually quick and straightforward, most toddlers will not willingly sit still while a wirelike device is passed through their nasolacrimal ducts, so general anesthesia is usually required. The AAPOS organization reports success rates of more than 90 percent for these tear duct probing procedures.